Provider Demographics
NPI:1144201450
Name:NUCLEAR STUDIES OF SOUTH FLORIDA,P.A.
Entity Type:Organization
Organization Name:NUCLEAR STUDIES OF SOUTH FLORIDA,P.A.
Other - Org Name:METABOLIC IMAGING OF BOCA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:KOTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-347-8077
Mailing Address - Street 1:PO BOX 11697
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33339-1697
Mailing Address - Country:US
Mailing Address - Phone:561-347-8077
Mailing Address - Fax:561-347-7731
Practice Address - Street 1:5458 TOWN CENTER RD
Practice Address - Street 2:SUITE 103
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1089
Practice Address - Country:US
Practice Address - Phone:561-347-8077
Practice Address - Fax:561-347-7731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207UN0902X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV2296OtherBLUE CROSS BLUE SHIELD
FL266567OtherAVMED
FL266567OtherAVMED
FLE5434Medicare ID - Type Unspecified